Article ID Journal Published Year Pages File Type
3335602 Transfusion and Apheresis Science 2013 4 Pages PDF
Abstract

A 70 year old Caucasian woman with IgG lamda multiple myeloma presented with uncontrollable bleeding from a bone marrow biopsy site which started days after the procedure. The patient was hyperviscous, and coagulation tests showed elevated activated partial thromboplastin time (aPTT) which was not corrected with a mixing study, elevated thrombin time and reptilase time, and possible inhibitors to Factors VIII and IX. Therapeutic plasma exchange was performed using plasma with corrections of plasma viscosity (1.6 to 1.1 centipoise) and aPTT (50 to 42.1 s) observed. The bleeding was controlled, and purified IgG demonstrated dysfibrinogenemic effects of the patient’s paraprotein.

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